The CHADS sub(2) and CHA sub(2)DS sub(2)-VASc scores predict new occurrence of atrial fibrillation and ischemic stroke

Background: Early identification of individuals who are at risk of developing atrial fibrillation (AF) and ischemic stroke may enable a closer surveillance and thus prompt initiation of oral anticoagulation for stroke prevention. Objective: This study sought to investigate whether congestive heart failure, hypertension, age greater than or equal to 75 years, diabetes, previous stroke (CHADS sub(2)) and CHA sub(2)DS sub(2)-vascul ar disease, age 65-74 years, sex category (CHA sub(2)DS sub(2)-VASc) scores can predict new-onset AF and/or ischemic stroke in patients presenting with arrhythmic symptoms. Methods and results: We prospectively followed up 528 patients (68.5 plus or minus 10.6 years, male 46.2 %) presented for assessment of arrhythmic symptoms but without any documented arrhythmia, including AF for development of new-onset AF and/or ischemic stroke. Their mean CHADS sub(2) and CHA sub(2)DS sub(2)-VASc scores on presentation were 1.3 plus or minus 1.3 and 2.3 plus or minus 1.5, respectively. After 6.1 years, 89 patients (16.8 %, 2.77 per 100 patient-years) had documented AF, and 65 patients (12.3 %, 2.0 per 100 patient-years) suffered stroke. Both the CHADS sub(2) (C statistic 0.63, 95 % confidence interval (CI) 0.58-0.67, P